Traumatic brain injury rates extremely high in Northwest Alaska
July 8th, 2011 | Alex DeMarban
A new analysis of traumatic brain injuries in Alaska shows the Northwest Alaska region with the highest hospitalization rates by far, more than quadrupling the statewide average and more than doubling rates in any other region.
It also shows that Alaska Natives are far more likely to suffer a traumatic brain injury than other Alaskans.
The new information has spurred the Alaska Brain Injury Network and the regional health association to hold upcoming meetings in Kotzebue, the hub community for 11 Northwest villages, to determine the amount of services available for long-term treatment.
Many people assume that serious head injuries are often like other medical conditions: You're cured once you're out of the hospital, said Jill Hodges, director of the network.
"But really, brain injury can be a lifelong chronic issue," she said. "So just like someone would have to monitor diabetes and work with that chronic disease, a lot of people have to work with traumatic brain injury over a lifetime to manage it."
The Northwest region had 411 brain injuries per 100,000 people, between 2004 and 2008, according to information provided by Hodges.
The next highest numbers in the state were found in the Nome region, with 196 per 100,000, followed by Bristol Bay at 174 and the Yukon-Kuskokwim Delta at 167.
The statewide average was 92, a rate similar to the national average.
The numbers were produced in May, using the latest information from the Alaska Trauma Registry. It was compiled by the Alaska Native Tribal Health Consortium.
Regions were divided along health-system lines. So for example, the Northwest numbers are from the 12 communities served by the Maniilaq Association, a tribally run health care system for the region.
Determining why the rates are so high in Northwest and other rural areas will require more exhaustive research, said Hillary Strayer, senior injury prevention specialist for ANTHC.
One important factor: Wearing helmets goes against cultural norms and snowmachine and ATV accidents are common in Northwest, said Golden Viveiros, Maniilaq's injury prevention coordinator.
Viveiros has stopped to talk with riders who weren't wearing helmets. Many say they don't know where to buy them.
But they still don't want a helmet after she tells them the nonprofit health association sells them well below retail prices.
"They say, 'No I don't go that fast. I drive pretty careful. The speed limit is only 25 mph.' "
But even below that speed, "they're still at risk for brain injury," she said.
"We have to change our paradigm of ATV and snowmachine safety to include the use of helmets, versus just driving carefully," she said.
Maniilaq's injury prevention program was revived last fall after a three-year lull, she said. The new staff, including Viveiros, is focused on getting into schools to teach students about the value of wearing helmets.
Next week, Maniilaq will film a public service announcement about wearing helmets while riding ATVs, she said. She and others have also met with younger students to promote bike helmets.
Maniilaq is also working with the brain injury network.
The network will hold a meeting on July 13 at the Northwest Arctic Borough Assembly Chambers starting at 9 a.m. Public testimony will be taken for an hour starting at 3:30 p.m. On July 14, board members and staff will get into the community and tour health facilities and meet caregivers in Kotzebue.
On July 15, experts on brain injury and injury prevention will provide training for caregivers and others in a meeting titled "Brain Injury Prevention, Early Management, Interventions and Challenges." That's at the borough chambers, from 8 a.m. to 12:30 p.m.
Statewide, Alaska Native rates are also high, at 174 per 100,000, said Strayer.
Speculating, she pointed to the common use of snowmachines and ATVs in predominantly Native villages as one reason for those high rates.
Getting a better answer will require more research, but there aren't plans and funding for that work at the moment, she said.
As for long-term care for traumatic brain injury in Kotzebue, the network can request support from the state Legislature or the Department of Health and Social Services if local programs are lacking, said Hodges.
The network can also provide technical support if people want to form local support groups, she said.
"This is a fact-finding mission," she said. "The board hasn't visited Kotzebue since 2005, so it's been six years, and we'd like to see what services are available."
Alex DeMarban can be reached at firstname.lastname@example.org